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Rehabilitation (Stuttg) 2000; 39(6): 324-337
DOI: 10.1055/s-2000-8940
ORIGINALARBEIT
© Georg Thieme Verlag Stuttgart · New York

Soziale Integrationsförderung als Aufgabe der Rehabilitation in der pädiatrischen Onkologie

Th. Kroll1 , F. Petermann2
  • 1National Rehabilitation Hospital, Center for Health and Disability Research, Washington, D.C., USA
  • 2Zentrum für Rehabilitationsforschung, Abteilung für Klinische Psychologie, Universität Bremen
Further Information

Publication History

Publication Date:
31 December 2000 (online)

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Zusammenfassung.

Mit zunehmend besseren Langzeitprognosen von Krebserkrankungen des Kindes- und Jugendalters rücken vermehrt verzögert auftretende physische und psychosoziale Komplikationen in den Mittelpunkt des Forschungsinteresses. In diesem Beitrag werden soziale und schulische Integration als Schwerpunkte der pädiatrisch-onkologischen Rehabilitation vor dem Hintergrund eines erweiterten Rehabilitationsverständnisses beschrieben. Bisher existieren in Deutschland nur wenige standardisierte Programme zur Förderung der schulischen und sozialen Eingliederung. Voraussetzungen für die Entwicklung von Eingliederungsprogrammen werden diskutiert und Programmansätze skizziert.

Social Reintegration as a Rehabilitative Task in Paediatric Oncology.

Survival rates of most paediatric cancers are steadily improving as a result of improvements in diagnostics and treatment protocols. Long-term survival renders physical late effects and psychosocial adjustment problems ever more visible. The focus of this article is on school re-entry and social reintegration as core tasks of comprehensive rehabilitation efforts. So far only few systematic programmes exist in Germany to facilitate school re-entry and social integration of paediatric cancer survivors. The article outlines the prerequisites for such interventions and provides examples of re-entry programmes.

Schlüsselwörter:

Pädiatrische Onkologie - Psychosoziale Anpassung - Rehabilitation - Schulische Wiedereingliederung

Key words:

Paediatric oncology - Psychosocial adjustment - Rehabilitation - School re-entry

Literatur

  • 1 Achenbach T. Manual for the Child Behavior Checklist/4 - 18 and 1991 Profile. Burlington; University of Vermont 1993
    Google Scholar
  • 2 Allen R, Newman S P, Souhami R L. Anxiety and depression in adolescent cancer: findings in patients and parents at the time of diagnosis.  European Journal of Cancer. 1997;  33 ((8)) 1250-1255
    CrossrefPubMedGoogle Scholar
  • 3 Andrews M, Wallis M. Mentorship in nursing: a literature review.  Journal of Advanced Nursing. 1999;  29 ((1)) 201-207
    CrossrefPubMedGoogle Scholar
  • 4 Anholt U V, Fritz G K, Keener M. Self-concept in survivors of childhood and adolescent cancer.  Journal of Psychosocial Oncology. 1993;  11 ((1)) 1-16
    PubMedGoogle Scholar
  • 5 Aquino V M, Fort D W, Kamen B A. Carboplatin for the treatment of children with newly diagnosed optic chiasmgliomas: a phase II study.  Journal of Neurooncology. 1999;  41 ((3)) 255-259
    PubMedGoogle Scholar
  • 6 Argerakis G P. Psychosocial considerations of the post-treatment of head and neck cancer patients.  Dental Clinics of North America. 1990;  34 ((2)) 285-305
    PubMedGoogle Scholar
  • 7 Barondess J A. Mentoring in biomedicine.  Journal of Laboratory and Clinical Medicine. 1997;  129 ((5)) 487-491
    CrossrefPubMedGoogle Scholar
  • 8 Baysinger M, Heiney S P, Creed J M, Ettinger R S. A trajectory approach for education of the child/adolescent with cancer.  Journal of Pediatric Oncology Nursing. 1993;  10 ((4)) 133-138
    PubMedGoogle Scholar
  • 9 Blakeney P. School reintegration.  Journal of Burn Care and Rehabilitation. 1995;  16 ((2)) 180-187
    PubMedGoogle Scholar
  • 10 Bradford R. Children, families and chronic disease. London; Routledge 1997
    Google Scholar
  • 11 Bukowski W M, Sandberg D. Peer relationships and quality of life.  Acta Paediatrica. 1999;  88 ( Suppl (428)) 109
    PubMedGoogle Scholar
  • 12 Bundesarbeitsgemeinschaft für Rehabilitation .Positionspapier zur Weiterentwicklung der medizinischen, beruflichen und sozialen Rehabilitation in der 14. Legislaturperiode, beschlossen am 15.12.1998. Frankfurt/M; BAR 1999
    Google Scholar
  • 13 Chin D G, Schonfeld D J, O'Hare L L. et al . Elementary school-age children's developmental understanding of the causes of cancer.  Developmental and Behavioral Pediatrics. 1998;  19 ((6)) 397-403
    PubMedGoogle Scholar
  • 14 Cleave H, Charlton A. Evaluation of a cancer-based coping and caring course used in three different settings.  Child Care Health and Development. 1997;  23 ((5)) 399-413
    PubMedGoogle Scholar
  • 15 Coie J D, Dodge K A, Coppotelli H. Dimensions and types of social status: A cross-age perspective.  Developmental Psychology. 1982;  18 557-570
    CrossrefPubMedGoogle Scholar
  • 16 Cole Levy K, Roberts M C, McNeal R E. Children's perceptions of ill peers: effects of disease grade, and impact variables.  Children's Health Care. 1996;  25 ((2)) 107-116
    PubMedGoogle Scholar
  • 17 Dalley M B, Bolocofsky D N, Karlin N J. Teacher-ratings and self-ratings of social competency in adolescents with low- and high-depressive symptoms.  Journal of Abnormal Child Psychology. 1994;  22 ((4)) 477-485
    PubMedGoogle Scholar
  • 18 Deasy-Spinetta P. School issues and the child with cancer.  Cancer. 1992;  71 ((10 Suppl)) 3261-3264
    PubMedGoogle Scholar
  • 19 Durkin K. Developmental social psychology: From infancy to old age. Oxford; Blackwell 1995
    Google Scholar
  • 20 Eiser C. Practioner review: long-term consequences of childhood cancer.  Journal of Child Psychology and Psychiatry. 1998;  39 (<(5)/IP>) 621-633
    CrossrefPubMedGoogle Scholar
  • 21 Eiser C. Vorstellungen über Körperfunktionen und Krankheit bei Kindern. In: Seiffge-Krenke I (Hrsg) Krankheitsverarbeitung bei Kindern und Jugendlichen. (Jahrbuch der medizinischen Psychologie 4). Berlin; Springer 1990: 25-28
    Google Scholar
  • 22 Eiser C, Havermans T. Long term social adjustment after treatment for childhood cancer.  Archives of Diseases in Childhood. 1994;  70 66-70
    PubMedGoogle Scholar
  • 23 Ellerton M L, Turner C. „Back to school” - An evaluation of a reentry program for school-aged children with cancer.  Canadian Oncology Nursing Journal. 1992;  2 ((1)) 8-11
    PubMedGoogle Scholar
  • 24 Erwin P. Friendship and peer relations in children. Chichester; Wiley 1993
    Google Scholar
  • 25 Evans S E, Radford M. Current lifestyle of young adults treated for cancer in childhood.  Archives of Diseases in Childhood. 1995;  72 ((5)) 423-426
    PubMedGoogle Scholar
  • 26 Gallo A M, Breitmayer B J, Knafl K A, Zoeller H. Stigma in childhood chronic illness: A well sibling perspective.  Pediatric Nursing. 1991;  17 ((1)) 21-25
    PubMedGoogle Scholar
  • 27 Gemeinsame Rahmenempfehlung zur ambulanten und stationären Vorsorge und Rehabilitation. Reha-Info der BAR 1999 (4): 8-10
    Google Scholar
  • 28 Grovas A, Fremgen A, Rauck A. et al . The National Cancer Data Base report on patterns of childhood cancers in the United States.  Cancer. 1997;  80 ((12)) 2321-2332
    CrossrefPubMedGoogle Scholar
  • 29 Häberle H, Schwarz R, Mathes L. Familienorientierte Betreuung bei krebskranken Kindern und Jugendlichen.  Praxis der Kinderpsychologie und Kinderpsychiatrie. 1997;  46 ((6)) 405-419
    PubMedGoogle Scholar
  • 30 Hansen M C, Hayes P A. Integrating students into interdisciplinary teams: extending the caring circle.  Seminars for Nurse Managers. 1998;  6 ((4)) 214-218
    PubMedGoogle Scholar
  • 31 Harms D. Kieler Kindertumorregister.  Deutsches Ärzteblatt. 1996;  93 ((12)) A- 746-A- 756
    PubMedGoogle Scholar
  • 32 Hartup W W, French D C, Laursen B, Johnston K M, Ogawa J R. Conflict and friendship relations in middle childhood: Behavior in a closed-field situation.  Child Development. 1993;  64 445-454
    PubMedGoogle Scholar
  • 33 Hepler J B. Evaluating a social skills program for children with learning disabilities.  Social Work with Groups. 1997;  20 ((3)) 21-36
    PubMedGoogle Scholar
  • 34 Hill D E, Ciesielski K T, Sethre-Hofstad L, Duncan M H, Lorenzi M. Visual and verbal short-term memory deficits in childhood leukemia survivors after intrathecal chemotherapy.  Journal of Pediatric Psychology. 1997;  22 ((6)) 861-870
    PubMedGoogle Scholar
  • 35 Hokken-Koelega A C, Van Doorn J W, Hahlen K. et al . Long-term effects of treatment for acute lymphoblastic leukemia with and without cranial irradiation on growth and puberty: A comparative study.  Pediatric Research. 1993;  33 ((6)) 577-582
    PubMedGoogle Scholar
  • 36 Ilveskoski I, Saarinen U M, Wiklund T. et al . Growth impairment and growth hormone therapy in children treated for malignant brain tumours.  European Journal of Pediatrics. 1997;  156 ((10)) 764-769
    CrossrefPubMedGoogle Scholar
  • 37 Jenkin D, Danjou C, Greenberg M. Subsequent quality of life for children irradiated for a brain tumor before age four years.  Medical and Pediatric Oncology. 1998;  31 ((6)) 506-511
    CrossrefPubMedGoogle Scholar
  • 38 Kaatsch P, Kaletsch U, Spi C, Michaelis J. Jahresbericht des Deutschen Kinderkrebsregisters. Mainz; 1999
    Google Scholar
  • 39 Keengwe I N, Stansfield F, Eden O B, Nelhans N D, Dearlove O R, Sharples A. Paediatric oncology and intensive care treatments: changing trends.  Archives of Diseases in Childhood. 1999;  80 553-555
    PubMedGoogle Scholar
  • 40 Koomen W, Dijker A J. Ingroup and outgroup stereotypes and selective processing.  European Journal of Social Psychology. 1997;  27 589-601
    CrossrefPubMedGoogle Scholar
  • 41 Kroll T. Soziale und schulische Integration von krebskranken Kindern und Jugendlichen. Berlin; dissertation.de Verlag im Internet 2000
    Google Scholar
  • 42 Krueger R A. Focus Group Kit 6: Analysing and reporting focus group results. London; Sage 1998
    Google Scholar
  • 43 Ladd G W, Kochenderfer B J, Coleman C C. Classroom acceptance, friendship, and victimization: Distinct relational systems that contribute uniquely to children's school adjustment?.  Child Development. 1997;  68 ((6)) 1181-1197
    PubMedGoogle Scholar
  • 44 LaMontagne L L, Wells N, Hepworth J T, Johnson B D, Manes R. Parent coping and child distress behaviors during invasive procedures for childhood cancer.  Journal of Pediatric Oncology Nursing. 1999;  16 ((1)) 3-12
    CrossrefPubMedGoogle Scholar
  • 45 Levendosky A A, Okun A, Parker J G. Depression and maltreatment as predictors of social competence and social problem-solving skills in school-age children.  Child Abuse and Neglect. 1995;  19 ((10)) 1183-1195
    CrossrefPubMedGoogle Scholar
  • 46 Lombardi F, Navarria P, Gandola L. The evolving role of radiation therapy in the optimal multimodality treatment of childhood cancer.  Tumori. 1998;  84 270-273
    PubMedGoogle Scholar
  • 47 Lovblad K, Kelkar P, Ozdoba C. et al . Pure methotrexate encephalopathy presenting with seizures: CT and MRI features.  Pediatric Radiology. 1998;  28 ((2)) 86-91
    CrossrefPubMedGoogle Scholar
  • 48 McCarthy M, Williams J, Plumer C. Evaluation of a school re-entry nursing intervention for children with cancer.  Journal of Pediatric Oncology Nursing. 1998;  15 ((3)) 143-152
    CrossrefPubMedGoogle Scholar
  • 49 Mott M G, Mann J R, Stiller C A. The United Kingdom Children's Cancer Study Group - the first 20 years of growth and development.  European Journal of Cancer. 1997;  33 ((9)) 1448-1452
    CrossrefPubMedGoogle Scholar
  • 50 Mulhern R K. Neuropsychological late effects. In: Bearison DJ, Mulhern RK Pediatric Psychooncology. New York; Oxford University Press 1994: 99-121
    Google Scholar
  • 51 Nassau J H, Drotar D. Social competence among children with central nervous system-related chronic health conditions: a review.  Journal of Pediatric Psychology. 1997;  22 ((6)) 771-793
    PubMedGoogle Scholar
  • 52 National Center for Education Statistics .Internet access in U.S. public schools and classrooms: 1994 - 1999. Washington, D.C.; U.S. Department of Education 2000
    Google Scholar
  • 53 Neglia J. P. Late effects of treatment in children with cancer.  Seminars in Pediatric Surgery. 1993;  2 ((1)) 29-36
    PubMedGoogle Scholar
  • 54 Newcomb A F, Bukowski W M. A longitudinal study of the utility of social preference and social impact sociometric classification schemes.  Child Development. 1984;  55 1434-1447
    PubMedGoogle Scholar
  • 55 Noeker M, Petermann F. Interventionsverfahren bei chronisch kranken Kindern und deren Familien. In: Petermann F (Hrsg) Lehrbuch der Klinischen Kinderpsychologie und -psychotherapie. Göttingen; Hogrefe 1999
    Google Scholar
  • 56 Noll R B, Bukowski W M, Hobart Davies W, Koontz K, Kulkarni R. Adjustment in the peer system of adolescents with cancer: A two-year study.  Journal of Pediatric Psychology. 1993;  18 ((3)) 351-364
    PubMedGoogle Scholar
  • 57 Oeffinger K C, Eshelman D A, Tomlinson G E, Buchanan G R. Programs for adult survivors of childhood cancer.  Journal of Clinical Oncology. 1998;  16 ((8)) 2864-2867
    PubMedGoogle Scholar
  • 58 Parker J G, Asher S R. Friendship and friendship quality in middle childhood: Links with peer group acceptance and feelings of loneliness and social dissatisfaction.  Developmental Psychology. 1993;  29 611-621
    CrossrefPubMedGoogle Scholar
  • 59 Petermann F, Kroll T. Psychosoziale Folgen bei Krebserkrankungen im Kindes- und Jugendalter.  Kindheit und Entwicklung. 1996;  5 ((4)) 209-214
    PubMedGoogle Scholar
  • 60 Petermann F, Kroll T, Schwarz B. Familienorientierte Rehabilitation krebskranker Kinder. Frankfurt/M; Peter Lang 1994
    Google Scholar
  • 61 Petermann U, Petermann F. Training mit sozial unsicheren Kindern. Weinheim; PVU 1996
    Google Scholar
  • 62 Pyke-Grimm K A, Degner L, Small A, Mueller B. Preferences for participation in treatment decision making and information needs of parents of children with cancer: a pilot study.  Journal of Pediatric Oncology Nursing. 1999;  16 ((1)) 13-24
    CrossrefPubMedGoogle Scholar
  • 63 Ragins B R, Cotton J L. Mentor functions and outcomes: A comparison of men and women in formal and informal mentoring relationships.  Journal of Applied Psychology. 1999;  84 ((4)) 529-550
    CrossrefPubMedGoogle Scholar
  • 64 Ries L A, Wingo P A, Miller D S. et al . The annual report to the nation on the status of cancer, 1973 - 1997, with a special section on colorectal cancer.  Cancer. 2000;  88 ((10)) 2398-2424
    CrossrefPubMedGoogle Scholar
  • 65 Ris M D, Noll R B. Long-term neurobehavioral outcome in pediatric brain tumor patients: review and methodological critique.  Journal of Clinical and Experimental Neuropsychology. 1994;  16 ((1)) 21-42
    PubMedGoogle Scholar
  • 66 Rynard D W, Chambers A, Klinck A M, Gray J D. School support programs for chronically ill children: Evaluating the adjustment of children with cancer at school.  Children's Health Care. 1998;  27 ((1)) 31-46
    PubMedGoogle Scholar
  • 67 Sandberg D E, Ognibene T C, Brook A E. et al . Academic outcomes among children and adolescents receiving growth hormone therapy.  Children's Health Care. 1998;  27 ((4)) 265-281
    PubMedGoogle Scholar
  • 68 Santilli L E, Roberts M C. Children's perceptions of ill peers as a function of illness conceptualization and attributions of responsibility: AIDS as a paradigm.  Journal of Pediatric Psychology. 1993;  18 ((2)) 193-207
    PubMedGoogle Scholar
  • 69 Schwartz C. L. Long-term survivors of childhood cancer: the late effects of therapy.  Oncologist. 1999;  4 ((1)) 45-54
    PubMedGoogle Scholar
  • 70 Seiffge-Krenke I, Boeger A, Schmidt C, Kollmar F, Floss A, Roth M. Chronisch kranke Jugendliche und ihre Familien: Belastungen, Bewältigung und psychosoziale Folgen. Stuttgart; Kohlhammer 1996
    Google Scholar
  • 71 Shelby M D, Nagle R J, Barnett-Queen L L, Quattlebaum P D, Wuori D F. Parental reports of psychosocial adjustment and social competence in child survivors of acute lymphocytic leukemia.  Children's Health Care. 1998;  27 ((2)) 113-129
    PubMedGoogle Scholar
  • 72 Sipe C L, Roder A E. Mentoring school-age children: A classification of programs. Washington D.C.; U.S. Department of Education, Office of Educational Research and Improvement 1999
    Google Scholar
  • 73 Socialstyrelsen Centre for Epidemiology .Cancer incidence in Sweden 1997. Annual Report. Stockholm; 1999
    Google Scholar
  • 74 Spirito A, Stark L J, Cobiella C, Drigan R, Androkites A, Hewett K. Social adjustment of children successfully treated for cancer.  Journal of Pediatric Psychology. 1990;  15 ((3)) 359-371
    PubMedGoogle Scholar
  • 75 Stangor C, McMillan D. Memory for expectancy-congruent and expectancy-incongruent information: A review of the social and social developmental literatures.  Psychological Bulletin. 1992;  111 100-117
    PubMedGoogle Scholar
  • 76 Statens helsetilsyn. Veileder i habilitering av barn og unge. Oslo; 1997
    Google Scholar
  • 77 Suh D W, Ruttum M S, Stuckenschneider B J, Mieler W F, Kivlin J D. Ocular findings after bone marrow transplantation in a pediatric population.  Ophthalmology. 1999;  106 ((8)) 1564-1570
    CrossrefPubMedGoogle Scholar
  • 78 Varni J W, Katz E R. Stress, social support and negative affectivity in children with newly diagnosed cancer: a prospective transactional analysis.  Psychooncology. 1997;  6 ((4)) 267-278
    CrossrefPubMedGoogle Scholar
  • 79 Varni J W, Setoguchi Y. Correlates of perceived physical appearance in children with congenital/acquired limb deficiencies.  Journal of Developmental and Behavioral Pediatrics. 1991;  12 ((3)) 171-176
    PubMedGoogle Scholar
  • 80 Varni J W, Katz E R, Colegrove Jr  R, Dolgin M. Family functioning predictors of adjustment in children with newly diagnosed cancer: A prospective analysis.  Journal of Child Psychology and Psychiatry. 1996;  37 ((3)) 321-328
    PubMedGoogle Scholar
  • 81 Varni J W, Katz E R, Colegrove Jr R, Dolgin M. The impact of social skills training on the adjustment of children with newly diagnosed cancer.  Journal of Pediatric Psychology. 1993;  18 ((6)) 751-767
    PubMedGoogle Scholar
  • 82 Varni J W, Katz E R, Colegrove R, Dolgin M. Adjustment of children with newly diagnosed cancer: Cross-informant variance.  Journal of Psychosocial Oncology. 1995;  13 ((4)) 23-37
    PubMedGoogle Scholar
  • 83 Walters E. Problems faced by children and families living with visible differences. In: Lansdown R, Rumsey N, Bradbury E, Carr T, Partridge J (Hrsg) Visibly different: Coping with disfigurement. Oxford; Butterworth & Heinemann 1997: 112-120
    Google Scholar
  • 84 Weitzman M. School and peer relations.  Pediatric Clinics of North America. 1984;  31 59-60
    PubMedGoogle Scholar
  • 85 Wendt A, Petermann F, Rölver K M, Schidlmeier A, Hanke U. Soziale Kompetenz in Beruf und Alltag: Ein intensives Gruppentraining für Typ-I-Diabetiker. In: Petermann F (Hrsg) Patientenschulung und Patientenberatung. Ein Lehrbuch. 2., vollständig überarb. u. erw. Aufl. Göttingen; Hogrefe 1997: 263-279
    Google Scholar
  • 86 Winker M A. et al . Guidelines for medical health information sites on the Internet: Principles governing AMA web sites.  Journal of the American Medical Association. 2000;  238 ((12)) 1600-1606
    PubMedGoogle Scholar
  • 87 Wiedebusch S. Krankheitskonzepte von Kindern und Jugendlichen mit juveniler chronischer Arthritis. Dissertation. Göttingen; Hogrefe 1992
    Google Scholar

1 Anm.: Es ist durchaus möglich, dass in einzelnen Einrichtungen jährlich mehr als die angegebene Zahl der Kinder behandelt, diese jedoch nicht dem Deutschen Kinderkrebsregister gemeldet wurden.

Dr. Thilo Kroll

National Rehabilitation Hospital Center for Health and Disability Research

1016 16th Street, N.W., 4th> Floor

Washington, D.C.

USA

Email: txk6@mhg.edu

Prof. Dr. Franz Petermann

Zentrum für Reha-Forschung Abteilung für Klinische Psychologie Universität Bremen

Grazer Straße 6

28359 Bremen

Email: Fpeterm@uni-bremen.de